Certified Once Accepted Everywhere. The IAF Initiative for Accredited Certification to ISO Medical Devices

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1 Certified Once Accepted Everywhere The IAF Initiative for Accredited Certification to ISO Medical Devices

2 Contents Introduction 3 ISO accredited certification within a national regulatory framework 4 Relationship to guidance from the Global Harmonization Task Force (GHTF) 6 How ISO certification relates to product certification 7 The IAF Multilateral Recognition Arrangement (MLA) 8 Structure of the MLA 8 IAF MLA Mark 9 Key Features of the Initiative 10 Reports associated with the IAF Initiative 12 Using Accredited ISO Certification in Practice 13 2

3 Introduction The purpose of this brochure is to explain the benefits and use of the ISO Medical Device initiative developed by the International Accreditation Forum (IAF). The initiative enables IAF accredited certification bodies to provide consistent, credible certification to ISO The documents, developed as part of the IAF initiative, which are mandatory to both accreditation bodies within IAF and all certification bodies accredited by them to provide certification to ISO 13485, also enable national authorities with an opportunity to enhance their healthcare systems through the implementation of accredited ISO certification, without losing valuable access to medical devices that they are already using. This brochure describes the importance of accredited certification and the roles and responsibilities of the different stakeholders with an interest in this scheme. It explains the context within which ISO accredited certification is expected to be used and the links between this and medical device trade and public health. Objectives of the Initiative l l l Application of the initiative enables IAF accredited certification bodies to provide consistent, credible certification to ISO The initiative documents, which are mandatory to both accreditation bodies within IAF and all certification bodies accredited by them to provide certification to ISO To enable national authorities with an opportunity to enhance their healthcare systems through the implementation of accredited ISO certification, without losing valuable access to medical devices. This informative guidance is intended to help the understanding of the utilisation of ISO accredited certification. 3

4 ISO accredited certification within a national regulatory framework Granting healthcare practitioners access to medical devices that are made in another country is critical to all healthcare systems. Indeed, most countries import more medical devices than they export. Each country must sensibly regulate access to medical devices in order to protect their citizens from unsafe devices. Regulators are increasingly realizing the benefit of recognizing the quality management system standard ISO Medical Devices Quality Management Systems Requirements for Regulatory Purposes. This international standard provides the basis for medical device regulations to be harmonized around the world. Just as doctors and patients benefit from receiving medical devices made outside their country, medical device industries throughout the world benefit from being able to provide them. In 2011, there were 6.5 billion people in the world living in 192 countries. Many of these countries do not have harmonized medical device regulations to protect their citizens, yet the need to protect their citizens is great. As each nation develops its own national medical device regulations, the likely increased demand for national factory audits would become impossible to bear for a manufacturer. This would not merely result in a barrier to trade for the supplier, but also a barrier to care for the importing country. Many countries import more than 90% of their healthcare technologies. By utilizing the international standard ISO 13485, with cooperation of IAF member accreditation bodies, the medical device industry can be provided with one ISO certificate that can be accepted everywhere, while also meeting the importing countries demand for safe and effective medical devices. Use of this initiative very much depends upon awareness among the global regulatory community. In particular, organizations such as the Global Harmonization Task Force (GHTF), Pan American Health Organization (PAHO), Asian Harmonization Working Party (AHWP) and Association of Southeast Asian Nations (ASEAN) are very important to the harmonization of medical device regulations. However, even with the endorsement of such organizations, it is equally important that individual regulatory authorities are aware of the requirements and structure of this initiative. ISO is intended to address medical device regulatory requirements for a quality management system. Although ISO is based on the Quality Management Systems standard ISO 9001, it focuses less on business performance and more on risk management. ISO ensures that medical device manufacturers consistently produce medical devices that meet regulatory requirements and are designed and manufactured to be safe for their intended use. Many international regulators have directly or indirectly endorsed use of ISO as the model for meeting their own regulatory requirements for medical device manufacturing. Many countries have developed their medical device regulations using ISO or the criteria within it, and other countries are now using or beginning to use this same standard in their medical device regulations. 4

5 Medical device regulators, certification bodies and members of GHTF have worked together to provide a common framework for regulating medical devices. GHTF Study Group 3 has created several documents that provide helpful guidance on the application and interpretation of ISO GHTF Study Group 4 provides guidance on the methodologies and requirements for the audit of quality systems against ISO The IAF initiative enables consistent and credible ISO certification. Without the harmonization provided by IAF, there remains the potential for variations of credibility among issued ISO certificates. The IAF documents were created to be used for developing and improving medical device regulations around the world, while preventing unnecessary barriers to care at the national level. A summary of the relationships between key stakeholders is shown in the following diagram: PUBLIC HEALTH HEALTHCARE MEDICAL DEVICES PUBLIC HEALTHCARE PROTECTION Classified Low Risk Devices Exempt from ISO National Regulation Recognises ISO IAF Accredited Certificates Medical Device Registration IAF Mandatory Documents MD8 for application of ISO MD9 for application of ISO ISO Regulatory Authority (RA) Accreditation Body (AB) Conformity Assessment Body (CAB) Manufacturer of Medical Device ISO Accredited Certificate 5

6 Relationship to guidance from the Global Harmonization Task Force (GHTF) The IAF ISO medical devices initiative has been optimized using GHTF guidance. For many years, GHTF members have strived to create a system of documents that can form the basis for medical device regulatory programs worldwide. The IAF initiative utilizes GHTF guidance from Study Group 4 concerning regulatory auditing practices. The initiative incorporates this guidance to support an infrastructure that links regulatory authorities, accreditation bodies, certification bodies, and medical device manufacturers. The IAF initiative for ISO does not require use of any additional GHTF documents. IAF accredited certification does however support regulations that incorporate other GHTF guidance. If GHTF guidance is to be used in forming a new medical device regulation, the following uses of GHTF guidance should be considered. Guidance documents from GHTF Study Groups 1, 2, 3, and 5 describe core concepts for developing a harmonized medical device regulatory system. Regulators may reference such documents for use as criteria that manufacturers must follow or they may adopt the language directly into national law. GHTF Study Group 4's guidance relevant to IAF ISO accredited certification has already been included in the IAF Mandatory Document for the application of ISO/IEC (IAF MD9). Therefore regulators should make the medical device industry aware of any national deviations from the GHTF approach that could possibly cause manufacturers delays in compliance. It is also very important to consider the restrictions on legal access to medical devices that may result from imposing deviations. Note: Whilst the long-term future of the GHTF is not certain, as at 2011 the view of achieving harmonised regulatory requirements remains a highly desirable objective, particularly in view of the pressures of a globalised manufacturing market for medical devices and increasing demands to streamline regulatory processes in order to deliver high quality products to the marketplace with minimal delays. The GHTF regulator s group considered that the best way to achieve such an outcome was to develop a regulator-led harmonisation and collaboration group that would allow for more detailed discussion between members on the optimum ways to achieve harmonisation at an operational level. The strategy of achieving this, together with adequate input and advice from industry, was still under consideration in mid Regulatory bodies may not want or be able to fully implement all documents and requirements of the GHTF due to particular local or national concerns. 6

7 How ISO certification relates to product certification Although an audit performed under the ISO may include an examination of a product s design and development, ISO is not a product certification standard. The certification based on ISO is not directly linked to the specification of the manufactured products. ISO certification indicates that the processes for designing and manufacturing medical devices are appropriate for providing consistent product quality and safety. 7

8 The IAF Multilateral Recognition Arrangement (MLA) IAF is an organization of accreditation bodies and other interested stakeholders from more than 50 countries. Most accreditation bodies operate under the authority of their own nation s government and cooperate in the development and maintenance of Multilateral Recognition Arrangements (MLAs). Signatories to the IAF MLA agree to promote acceptance of accredited certificates issued by all the other IAF MLA signatories within the scope of the MLA. Thus the MLA underpins the recognition of ISO certificates issued by certification bodies accredited by IAF member accreditation bodies. Structure of the MLA Certificates issued by bodies accredited by the IAF MLA Signatories can be relied upon throughout the world because the MLA assures the credibility of the certificate to customers. The MLA is structured in 5 levels. ISO fits into these levels as follows: Level 1 Includes ISO/IEC and the IAF Mandatory document (MD8) on the application of ISO/IEC in Medical Device Quality Management Systems (ISO 13485); Level 2 Describes the type of conformity assessment activity e.g. Management Systems. The IAF accreditation system for ISO will form part of management system activities (no additional documentation required); Level 3 ISO/IEC 17021; Level 4 The sector specific requirements have been developed by the IAF Technical Committee and are contained in the IAF mandatory document (MD 9) on the application of ISO/IEC for the Medical Device Quality Management Systems (ISO 13485). Level 5 ISO Accreditation bodies that are signatories to the IAF MLA may extend their scope of operation to include medical devices if they accredit certification bodies that issue ISO certificates. They will do this either directly to IAF or through their regional group if the regional group includes ISO as part of their regional MLA. 8

9 IAF MLA Mark The documentation has been developed to ensure that the initiative gains as much advantage from the IAF MLA as possible by ensuring that accredited certificates issued to ISO are able to include the IAF MLA Mark,which is the IAF MLA Mark in combination with the symbol of the accreditation body. The IAF MLA Mark will not appear on certificates on its own. The IAF MLA mark s appearance on an ISO Certificate assures the user of the certificate that the ISO audit is highly credible and operating under IAF MLA Management. The Mark demonstrates that the certificate has been issued by a certification body that is accredited by an IAF MLA member and is thus traceable to the highest authority. It is an assurance that the certificate and the issuing body are of a high standard of competence and may be trusted, as they are recognised as complying to the same set of standards at the global level. To ensure that the IAF MLA Mark may be used on accredited certificates, the initiative has been endorsed by the IAF in accordance with the document IAF PL3. The IAF MLA mark can be used by accreditation bodies to demonstrate their status as a signatory to the IAF MLA. Accredited certification bodies can also use the mark in combination with the accreditation symbol on their certificates providing they are issued in association with IAF endorsed normative documents such as ISO

10 Key Features of the Initiative The relationship of Risk Classification of Medical Devices to QMS requirements The significance of risk classification to the QMS is that based on whether the medical device is higher or lower risk, the regulator may or may not require the manufacturer s quality management system to be independently certified to ISO The purpose of classification is to match regulatory oversight and market clearance to the level of risk of the device s risk. Lower risk medical devices usually do not require independent certification of the manufacturer s QMS. The illustration below is a very basic example of how ISO certification could be applied to four different risk classifications for medical devices: Manufacturer s Obligations to a Quality Management System Medical Device Risk Classification GHTF Risk Class IAF accredited certification to ISO Not Required IAF accredited certification to ISO Required IAF accredited certification to ISO Including Design and Development Controls High Risk Medium-high Risk Medium-low Risk Low Risk D C B A x* x x x *Low risk medical devices are exempt from ISO Certification 10

11 Two approaches to that are widely used to determine risk classification: Risk classification rules Risk classification rules use general principles of risk, related to patient contact with energy, substances, invasiveness into the body, as well as other criteria, to determine the risk level of a medical device. Higher risk devices have a contact with the body for a longer time period than lower risk devices. They are more invasive inside the body or rely on a more hazardous energy sources. Several risk rules can be found to apply to one medical device. It is the responsibility of the manufacturer to apply the higher risk classification when more than one risk classification is identified using applicable risk rules. A full list of risk classification rules can be viewed in the GHTF document SG1-N15: 2006 Principles of Medical Devices Classification. Risk classification names Risk classification names appear as an assigned risk classification next to the name of the medical device type (e.g. Blood Pressure Cuff Class B). The Medical Devices risk classifications are then made public and allow the regulatory authority to adjust the risk classification more easily, if post market experience shows a particular product to be more, or less safe than originally thought. Changing a risk classification for one product, does not change the risk classification of another. Risk classifications may be assigned by consensus from a group of medical device experts. Some medical device experts use risk classification rules to assign the first risk classification for a new type of medical device. Although the IAF initaitive for ISO does not prescribe any risk classification system, requirements for ISO certification should be based on the risk of a device to public health. 11

12 Reports associated with the IAF Initiative Reports exist on how the participants at the different layers within the IAF ISO certification initiative meet the particular requirements that are appropriate for them: Accreditation body peer evaluation report Medical device manufacturer s audit report Under the IAF MLA, a peer evaluation report covers the accreditation body s performance in meeting, among other things, the IAF Mandatory Document for the application of ISO/IEC Conformity Assessment General Requirements for Accreditation Bodies Accrediting Certification Bodies in the Medical Device Quality Management Systems (ISO 13485). Assessment report on the certification body Under the accreditation for ISO by IAF accreditation body members, the accreditation body provides an accreditation assessment report of a certification body s performance in meeting, among other things, the IAF Mandatory Document for the application of ISO/IEC Conformity Assessment Requirements for Bodies Providing Audit and Certification of Management Systems in the Medical Device Quality Management Systems (ISO 13485). This is the audit report prepared by the certification body that indicates the medical device manufacturer s performance in meeting, among other things, the requirements of the quality management system standard ISO Regulatory authorities that have specified the use of the IAF accredited ISO certification initiative in their legislation may be provided access to the accreditation body, certification body and the participating medical device manufacturer s reports and facilities. 12

13 Using Accredited ISO Certification in Practice Practical Aspects of Specifying IAF Accredited ISO Certificates in Medical Device Regulations Requirements for IAF accredited certification are designed to enforce one credible and transparent ISO audit to meet the needs of regulatory authorities. In order for this to occur, ISO certificates should be identified in the national medical device regulation through appropriate national legislative processes. By recognizing IAF accredited ISO certificates in the national legislation, countries gain access to the audit reports in addition to being able to inspect any participating accreditation body, certification body or medical device manufacturer. Although there are many ways in which ISO accredited certificates may be included into a new medical device regulation, the most likely approach would be to specify it as a requirement for registering medium\risk or higher risk medical devices with the Regulatory Authority. An example of how a national medical device regulation could reference IAF accredited ISO certificates is provided below. The use of the IAF accredited ISO certification program can make a significant contribution towards developing a harmonized medical device regulation. It does not, however, describe or mention Medical Device Reporting (MDR), how to classify the risk level of a medical device or how they should be labelled. IAF accredited ISO certificates are expected to be part of the medical device regulation that pertains to product registration and quality management system requirements. The GHTF provides free, detailed guidance at for developing a more complete and harmonized medical device regulation. [Regulation Number] Medical Device Registration An application for registering a class 2 or higher medical device shall be submitted to the [Name of Regulatory Authority] by the manufacturer and shall contain the following: a) A copy of a current and valid IAF accredited ISO quality management system certificate certifying that the quality management system under which the device is manufactured satisfies ISO Medical devices Quality management systems Requirements for regulatory purposes. b)...other requirement(s) 13

14 Using Accredited ISO Certification in Practice continued Considering exemptions for ISO certification In 2011, there are an estimated 5,000 different medical device categories that account for 90,000 different products used by healthcare systems worldwide. More than 50% of these medical devices are considered low risk. Many low risk medical devices are safer than less regulated consumer products. Allowing healthcare professionals access to a wider range of medical devices provides a necessary benefit to a country s healthcare system. Accredited ISO certification is suggested for regulating medium to high risk medical devices. Transition period for requiring IAF accredited ISO certificates Although it is expected that accredited certificates for ISO will become available within the first year of its adoption by IAF, regulators need to provide manufacturers with an opportunity to learn and adapt to any new regulation. Enforcing IAF accredited certification before industry has had time to prepare could have an adverse impact on the healthcare system if it is enforced too soon. Each country that adopts the IAF accredited certification to ISO into its regulations should make the new regulation as widely known as possible to provide medical device manufacturers time to prepare. It is recommended that a transition period of three years be provided to allow all stakeholders time to adjust to the IAF accreditation requirements. Communication between Stakeholders In order for this IAF accredited ISO Certification Initiative to contribute to an efficient regulatory system, it is vital for effective communication channels to exist between regulators, accreditation bodies and conformity assessment bodies. Communication is a key element of this initiative and is intended to support mutual confidence building. It is recommended that regulators establish a communication framework between them and their local accreditation body that is visible to the conformity assessment bodies and medical device manufacturers. 14

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16 Certified Once Accepted Everywhere IAF Secretariat Elva Nilsen 28 Chemin Old Chelsea Box 1811 Chelsea, Quebec CANADA J9B 1A0 Phone: +1 (613) IAF B5 1/2012

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